Syllabus of the Sub-Speciality Paediatric Urology
1. Normal and pathological embryology of the urinary and genital tract
1.1. Development of the kidney
1.2. Development of the urinary tract
1.3. Development of the gonads and genital tract
2. Nephrology
2.1. Normal physiology of the urinary tract and kidney
2.2. Pathophysiology of pre and postnatal hydronephrosis
2.3. Laboratory and diagnostic tests
2.3.1. Hematuria
2.3.1.1 Diagnostic procedures (imaging and endoscopic procedures)
2.3.2. Proteinuria
2.4. Acute kidney diseases and acute kidney injuries
2.4.1. Glomerular (glomerulonephritis, hemolytic-uremic-syndrome, IgAN-V)
2.4.2. Tubular (acute, acquired, hereditary diseases)
2.4.3. Interstitial
2.4.4. Infectious
2.5. Chronic Kidney Disease and dialysis
2.5.1. CKD international classification
2.5.2. Aetiology of chronic kidney disease
2.5.3. Symptoms and signs (CKD- hypertension and cardiovascular health, CKDMetabolic Bone Disorders)
2.5.4. Conservative treatment
2.5.5. Stones
2.6. Dialysis (indication, peritonealhaemodialysis)
2.6.1. Peritoneal dialysis
2.6.1.1 Principles
2.6.1.2 Peritoneal access
2.6.2. Hemodialysis
2.6.2.1 Principles
2.6.2.2 Vascular access
2.7. Kidney transplantation
2.7.1. Indications
2.7.2. Selection, risks and contra-indications
2.7.3. Immunology (principles)
2.7.4. Preparation and diagnostic work-up
2.7.5. Cadaveric and living donor kidney
2.7.6. Surgical technique of implantation, removal and technical complications
2.7.7. Euro-Transplant-organization rules
2.7.8. Post-transplant complications (principles)
3. Infection
3.1. Definition of UTI (asymptomatic bacteriuria, bacterial cystitis, pyelonephritis)
3.2. Diagnosis of UTI (microbiology, culture media, preparation techniques)
3.3. Specific infection: clinical features (abscess, tuberculosis, candida, eosinophilic cystitis, cystitis-cystica)
3.4. Orchitis, epididymitis
4. Principles in diagnosis of the urinary tract
4.1. History and physical examination of the child at different ages
4.2. Associated clinical signs with anomalies of the urinary tract
4.3. Urinalysis (stick, microscopic, chemical, culture)
4.4. Serum-analysis
4.5. Imaging of the urinary tract
4.5.1. Ultrasound, color Doppler: theory, possibilities and limitations
4.5.2. X-ray: protection principles (radiation safety) urography, cystography, videourodynamics
4.5.3. Contrast media: principles, indication and contra-indications
4.5.4. Computerized tomography (principles, interpretation, possibilities, limitations)
4.5.5. Magnetic Resonance Imaging (principles, interpretation, possibilities, limitations)
4.6. Imaging of the urinary tract using radioisotopes
4.6.1. Principles
4.6.2. Static imaging: DMSA
4.6.3. Dynamic imaging: DTPA, MAG-3
4.6.4. Interpretation of clearance and glomerular filtration rate: principles and limitations
4.6.5. Direct and indirect cystography
4.6.6. Extrarenal imaging: neuroblastoma
4.7. Prenatal diagnostic
4.7.1. Ultrasound
4.7.2. Urinalysis (electrolytes, tubular markers)
4.8. Non-invasive diagnostic of the lower urinary tract
4.8.1. Uroflowmetry (principles, methods, interpretation)
4.8.2. Electromyography (principles, methods, interpretation)
4.9. Invasive diagnostic techniques of the lower urinary tract
4.9.1. Antegrade and retrograde cystography (technique, interpretation)
4.9.2. Video-urodynamic study (technique, interpretation)
4.9.3. Cystometry (ambulatory and nonambulatory)
5. Pre-, peri- and postoperative management of the child - Anesthesia principles
5.1. Selection, pre-operative studies
5.2. Parental information pre- and postoperative
5.3. Ambulatory surgery
5.3.1. Selection
5.3.2. Local anesthesia techniques (methods, pharmacology)
5.4. Pain management (oral, rectal, parenteral)
5.5. Postoperative fluid management
5.6. Anaesthesia (principles, premedication)
6. Anomalies of the kidney and the upper urinary tract - Diagnostic, management, therapeutic options, surgery selection, surgical techniques of:
6.1. Prenatal hydronephrosis and associated problems (pulmonary hypoplasia)
6.2. Renal agenesis
6.3. Renal hypoplasia
6.4. Renal dysplasia (multicystic dysplastic kidney, cystic dysplasia with obstruction)
6.5. Renal duplication
6.6. Polycystic infantile and adult renal disease
6.7. Horseshoe-kidney
6.8. Renal ectopia
6.9. Uretero-pelvic junction obstruction (UPJ)
6.10. Megacalycosis
6.11. Ureterocele ( intra- and extravesical)
6.12. Ectopic ureter
7. Anomalies of the lower urinary tract - Diagnostic, management, therapeutic options, surgery selection, surgical techniques of:
7.1. Urachal pathology (open urachus, cysts, sinus, diverticulum)
7.2. Exstrophy – Epispadias - Complex
7.3. Bladder diverticulum
7.4. Urethritis posterior
7.5. Urethral strictures
7.6. Duplication of the urethra
7.7. Urethral diverticulum
7.8. Meatal prolapse
7.9. Urogenital sinus anomalies
7.10. Cloacal anomalies
8. Anomalies of the upper and lower urinary tract - Diagnostic, management, therapeutic options, surgery selection, surgical techniques of:
8.1. Primary mega ureter
8.2. Vesico-ureteral reflux
8.3. Prune-Belly-Syndrome
9. Anomalies of the penis - Diagnostic, management, therapeutic options, surgery selection, surgical techniques of:
9.1. Hypospadias
9.2. Phimosis (lichen sclerosus)
9.3. Epispadias
9.4. Buried penis
9.5. Penoscrotal web
9.6. Micropenis
10. Anomalies of the testis and the scrotum - Diagnostic, management, therapeutic options, surgery selection, surgical techniques of:
10.1. Maldescent of the testis (cryptorchism, ectopia, retractile)
10.2. Anorchia, polyorchia
10.3. Hydrocele, hernia
10.4. Varicocele,
10.5. Spermatocele
11. Disorders of Sexual differentiation
11.1. Embryology and physiology of genital differentiation
11.2. Evaluation at birth: diagnostic tools and multidisciplinary approach
11.3. Psychological support and legal concerns
11.4. Therapeutic options
11.5. Surgical treatment: timing, indications, outcome, techniques.
12. Function disorders of the lower urinary tract
12.1. Normal anatomy and physiology
12.2. Classification of functional disorders
12.3. Urinary diversion techniques
12.4. Non-neuropathic function disorders
12.5. Neuropathic function disorders: conservative treatment, bladder augmentation
12.6. Principles of management in associated neurogenic disorders (digestive, orthopedic, sexual, quality of life)
13. Primary monosymptomatic nocturnal eneuresis
13.1. Pathophysiology
13.2. Treatment options
14. Paediatric urology emergencies - Diagnostic, prevention and management, therapeutic options, surgery selection, surgical techniques of:
14.1. kidney infectious problems (pyonephrosis, renal abscess)
14.2. Acute kidney injury (trauma, renal vein thrombosis)
14.3. Ureteral trauma
14.4. Adrenal haemorrhage
14.5. Renal colic (acute upper urinary tract obstruction)
14.6. Urinary retention
14.7. Testicular torsion
14.8. Torsion of the appendix testis
14.9. Incarcerated hernia
14.10. Testicular rupture
14.11. Orchitis
14.12. Epididymitis
14.13. Paraphimosis
14.14. Priapism
14.15. Penile and scrotal trauma
14.16. Bladder trauma (intra- and extraperitoneal rupture)
14.17. Urethral rupture
14.18. Trauma of the female genital tract
14.19. Infection of the female genital tract (vulvovaginitis, foreign body)
14.20. Acute hydro- and haematocoele
14.21. Idiopathic scrotal oedema
15. Urolithiasis
15.1. Aetiology
15.2. Metabolic disorders
15.3. Chemical characteristics
15.4. Diagnosis and management
15.5. Treatment options
16. Paediatric urology oncology - Diagnostic, management, therapeutic options, surgery selection, surgical techniques of:
16.1. Wilms tumour
16.2. Neuroblastoma
16.3. Rhabdomyosarcoma
16.4. Testicular tumours (Leydig cell, Yolk Sac, Leukaemia)
16.5. Hypernephroma
16.6. Pheochromocytoma
17. Management and social aspects of the care of the child as a patient
17.1. Communication skills with the child and its family
17.2. Knowledge of the psychosocial and sexual development of a child
17.3. Child protection issues (sexual abuse)
17.3.1.Principles and rules for declaration to the authorities
17.4. Guide- line and anticipation for the transition to adult care